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Flaw In Emergency Response System May Have Killed Hundreds
Hugh Pickens writes "The Telegraph reports that a flaw in the way emergency response software was set up to handle Category A responses in Great Britain may have cost hundreds of lives over the past ten years. Most ambulance services use an international computerized system designed in America and in the US version, a fall of more than 6 feet receives the maximum priority response. However, the government committee which governs its use in Great Britain decided that such cases should be deemed less urgent, and excluded from an eight minute category A target response time. If a call involved a fall of more than 6 feet it was designated a lower priority 'category B response' despite the presence of life-threatening conditions which were supposed to receive the most urgent category A response. The flaw came to light after Bonnie Mason, 58, fell 12 feet down the stairs and died from a head injury after emergency controllers in Suffolk failed to identify her situation as 'life-threatening.'"
The summary sounds like "we underestimated how dangerous a medium distance fall can be, so we didn't have the correct priorities and more people died than could have". That isn't really a flaw in the algorithm, it's just a flaw in one specific parameter in the algorithm.
The system itself wasn't flawed, but rather whoever set it up decided that they should be category B. The system did exactly what it was told, it just was told to do something different than in the US, and something that was later deemed to be suboptimal.
How is this a flaw in the Emergency Response System if the change initiated by a government committee is how the incidents were classified wrongly?
Support NYCountryLawyer RIAA vs People
Revenge for that Mars probe metric conversion mishap
Table-ized A.I.
Caller: Please hurry!! He's fallen down a 30ft well! Can't you get here any faster!?
A&E Drone: *clackety clackety* ...... Computer say Nooooo....
May the Maths Be with you!
is more like falling 24 times 6 inches, right?
We have friends in England and one of them had her hip replaced. A couple weeks after she was able to walk on it, she was doing the dishes and the replacement broke -- basically either the hip or femur end broke and was completely out of socket. Her husband called 999 and the ambulance at first refused to come because it wasn't a life-threatening emergency. "Can she just walk to the car?" "Can you carry her to the car?" You can probably imagine your wife screaming in pain, you not knowing if some vein or artery has been sliced, and any movement at all just makes her scream more. "Yah, it's cool. I just duct taped her mouth and threw her over my shoulder. I think she's passed out from the pain so tossing her in the back seat should work a treat. We'll be at the hospital in no time!"
I realize a line needs to be drawn somewhere. Some people will call for an ambulance when they've cut themselves shaving. But you know, when you can hear the screams in the background...you should probably get off your asses and help out.
"However, the government committee which governs its use in Great Britain decided that such cases should be deemed less urgent, and excluded from an eight minute category A target response time." I just have to wonder, what was the make-up of this committee? Was it bureaucrats, or actual medical and emergency response professionals, or a combination of the two? What was the justification and evidence used to determine the likelihood of cases such as these to be life-threatening? If I lived in England, I would be calling for all of this to be reviewed.
The only thing necessary for evil to triumph is for it to be pitted against a slightly greater evil
I think that the comments I have read above me are missing the point, or maybe I am.
The software was changed so that falls of more than 6 feet no longer caused a case to be considered "category A", the problem is that (through a mistake when rewriting that bit of code I assume), mention of a fall was causing a case to be considered "category B" even if other things were present that would normally have made it "category A".
We should have them run our healthcare in the USA!
You're right: it isn't a flaw in the software per se, and I would not assign any blame to those who developed it (as opposed to those who implemented it).
However, it is a predictable of administration, and the use of information technology is often integrated into systems in just this way. The idea that risk can be rationalized and reduced to a number (class A, class B, and so on) is itself potentially dangerous. Though it is not necessarily dangerous in any particular situation, it is nevertheless predictable that administrative or technical rationality would make this kind of outcome more common.
You see, the problem was not simply that the response categories were incorrect. The problem was that the system (including its operators, operating procedures, and so on) was too rigid, too rationalized, and therefore unable to respond to unexpected events:
This kind of event was clearly unexpected by the systems implementors. But even if they had assessed the danger of falls differently, there is likely some other event that would fall outside the systems parameters. (Most falls probably should be category B events, not category A.) That's why you want to have human judgement and human overrides.
Treating a system in terms of independent technical components has a number of benefits, including efficiency. That's what happened here. The process was rationally divided into tasks for the humans and tasks for the computer. Nice, neat, clean: and likely to produce outcomes like this.
Is anyone else reminded of Star Control 2? The "peaceful" Slylandro probe... which was misconfigured with bad priorities.
Captain: Your probe DOES destroy ships and I can prove it!
Slylandro: No! It cannot! It is not programmed for hostile behavior! What is your reasoning?!
Captain: Think about what a probe does when it meets a ship.
Slylandro: Space ships are the probe's highest priority because we want more than anything to make friendly contact with alien races.
Captain: Think about a probe's Replication behavior.
Slylandro: The probe seeks raw materials, and processes them in preparation for Replication.
Captain: Think about the effect of changing the replication behavior's priority.
Slylandro: The answer is simple... it would spend more of its time seeking raw materials for its replication process. So what?
Captain: Now, what will it do to a ship, given that its Replication priority is set to maximum?
Slylandro: I don't see what you are getting at, but I'll play along with you.
Slylandro: Like I said, alien ships are THE top priority target. Once a probe scanned a ship, it would instantly move toward it. Then, when it got to the ship, it would initiate communication automatically. When communications were terminated, a new behavior would be selected, and...
Slylandro: Uh-oh.
Slylandro: A new behavior would be selected, and since the Replication setting was set to maximum the probe wouldn't get time to pick a new target... it would use the current target--the ship--for raw Replication materials. It would process the ship, break it into component compounds with electrical discharges.
Slylandro: Oh no! what have we done? Traveller! You must tell us what we can do! How can we stop the probes from destroying all life in the galaxy?!
F0 07 C7 C8
Good to know. If you're in the UK and you ever have to make an emergency response for someone who has fallen down some stairs, if it looks serious then lie. Not sure what though. Perhaps fallen down stairs into pool of crocodiles, that sounds pretty serious.
Loose lips lose spit.
Shouldn't the 911 operator taking the call be well trained enough to know what's life threatening and whats not? this culture of "the computer will do the thinking for us now" needs to stop.
If you mod me down, I will become more powerful than you can imagine....
May have killed hundreds...
May also have killed nobody.
How sensational!
"If you make people think they're thinking, they'll love you; But if you really make them think, they'll hate you." - DM
At least the Brits can be credited for the genius of their new number and catchy jingle. Oh one one eight, nine nine nine--eight eight one nine nine, nine one one nine seven two five! .... three.
People need to realize that there is a corporate executive who often stands between a patient and his or her doctor. That’s the reality. And I think the insurance industry is now fear-mongering during this debate on health care reform, saying that a government bureaucrat could stand between someone and his or her doctor. But the current situation is just as bad, if not worse, because you have people doing that now who are denying care to meet Wall Street’s expectations.
Wendell Potter is former head of corporate communications for Cigna Corporation, where he worked for 15 years. He is now a fellow at the Center for Media and Democracy.
http://news.newamericamedia.org/news/view_article.html?article_id=33655d70ff9cd7509f16bfd2bfbafa9f
Politicians on Capitol Hill have no trouble with committees that decide the fate of American lives. What they have a problem with is losing corporate donors. Private medical insurance agencies have a lot of lobbyists on the payroll.
Truthfully, the availability of a public option will ultimately save taxpayers money. We already foot the bill with higher hospital expenses and taxes when the poor have to wait until the last minute to receive care. When there's a public clinic that requires virtually no money to visit, people will get more effective and less expensive care earlier. Many of America's lower middle class will then opt out of the ridiculously expensive plans, so they can send their kids to college, or move to a safer neighborhood, or whatever. This will cut into the bottom line of insurance corporations, which is why they are fighting it so bitterly.
And the rich won't see anything change. They'll always pay for private "cadillac" plans, just like they do in Germany and England. They just don't want to lose profits in the insurance companies that they own, or - God forbid - have to pay the same tax rates that they did ten or fifteen years ago.
Comment removed based on user account deletion
Besides the questionable decision regarding the severity of a 6 foot fall, the flaw here seems to be the order in which the conditions were evaluated when determining which category should be assigned. It sounds like when they made the modification, they introduced a bug where a 6+ foot fall would force the call into category B, ignoring other serious condition entries that should have forced it into category A by themselves.
http://www.radiowiki.org.nz/index.php/ProQA
If its not a life critical, time sensitive emergency, don't call 9-1-1, or 9-9-9 or whatever the emergency number might be!
Sadly, you're assuming at least a semblance of rationality in a country where people will call 9-9-9 for an ambulance because they're too lazy to walk across the road to the hospital, or because they're drunk and want a ride home (read some of the British paramedics' blogs for even better stories).
That's what happens when you promise everyone 'free' healthcare... if it's free, why would you bother to walk or pay for a taxi?
It seems that what is lacking is the ratio ( deaths in mode X / deaths in mode Y ). So if they change it to category A and something else becomes category B by falling off the end, what death toll does that have and do they even know?
I would imagine that a call wouldn't be made if the fall didn't do much harm.
For example, I have fallen off a roof into a snow bank and was unharmed. No ambulance was called.
However, I imagine that if I had fallen and wasn't moving it would have been serious.
As with anything, initial common sense needs to be exercised. It's usually obvious when there is no harm, and often less obvious when there is more harm.
Make America grate again!
It is the distance traveled through the air to impact with the ground that matters. Falling down stairs does not count as a 6 foot fall. You are rolling down the steps with maybe a 2 foot fall. Falling off a stool is a 3+ foot fall.
If you fall 6 feet or more, you are likely to have serious head injury or broken bones. Remember, when one falls, one will most likely land on one's back and that means probably head impact.
There is no "-1 offended" or "-1 you don't agree with me" mod options for a reason.
The ambulance will only take you to the hospital. If the trip was deemed unnecessary and avoidable (or under false pretences), then you'll receive a sizeable invoice in the mail.
'Free' healthcare is not the bogeyman you think it is. Just because you don't become forever crushed by unrecoverable debt doesn't mean it's a free-for-all wanton orgy of people abusing the system.
How could such an audience miss this opportunity to quote Python (Monty)!
The ambulance will only take you to the hospital. If the trip was deemed unnecessary and avoidable (or under false pretences), then you'll receive a sizeable invoice in the mail.
Since when? I lived in the UK for years and never ever heard of a case where someone was billed for using a 'free' ambulance for spurious reasons.
Just because you don't become forever crushed by unrecoverable debt doesn't mean it's a free-for-all wanton orgy of people abusing the system.
So why do the actual paramedics who operate the actual ambulances have so many stories of people abusing the system in that way and putting lives at risk by diverting them from important work?
What's that in meters?
Have gnu, will travel.
I can imagine the deadly logic from the committee: People falling from more than 6 feet will probably die anyway, so let's concentrate on others who have more chance to survive -- and therefore pay their bills.
The only way to fix this will be to throw a few committee members from the roof and when their colleagues see what happens (nothing) they may reconsider...
Brin' Me A Ambalamp!
Tired of my customary (Score:1)
A couple of points
1. READ THE BLOODY ARTICLE
The high falls were less critical - translation, It has been determined that you are highly likely to die, so, if we are busy, we will try and save someone who can be saved.
2. It is in the Daily Telegraph so the story is most likely a beat up (think National Enquirer meets Fox)
We should consider who manages the emergency phone system. If you call and speak to a dispatcher, who trained that dispatcher? Who pays them? What kind of script do they follow on the phone?
It isn't too hard to imagine emergency dispatch becoming something similar to tech support - regardless of the country in question - where calls are themselves triaged and moved through levels until specific criteria are met. And for the Americans who think that this couldn't happen here, just tell me when the last time was that you were in an American emergency room and did not encounter a triage nurse?
Damn_registrars has no butt-hole. Damn_registrars has no use for a butt-hole.
The title of this thread is "Flaw In Emergency Response System May Have Killed Hundreds"
The first sentence contains the following: "... a flaw in the way emergency response software was set up to handle Category A responses in Great Britain may have cost hundreds of lives over the past ten years"
BOTH ARE VERY MISLEADING !!
The FLAW of the whole thing is the BRITISH GOVERNMENT COMMITTEE which decides that a fall of more than six (6) feet SHOULD BE DEEMED LESS URGENT, AND EXCLUDED FROM AN EIGHT (8) MINUTE CATEGORY A TARGET RESPONSE TIME " !!
Why blame the software or the emergency controllers when it's the idiotic British bureaucracy which has fcuked up in the first place?
Muchas Gracias, Señor Edward Snowden !
more than a flaw in the system, doesn't it?
--
Stay tuned for some shock and awe coming right up after this messages!
There weren't resources in American hospitals to tread them promptly enough to prevent permanent disability? Which hospital? What insurance plan? What was the illness?
A fall down the stairs is sort of one stair at a time. In a way people only fall about ten inches but do it over and over again until they hit bottom. I can see why defining a category for falls could be quite confusing as far as writing response software is concerned. A lot of us have fallen down stairs quite a distance and not been injured at all.
Here, I believe that any ambulance call involves a high speed response. It may be that certain areas are simply not keeping enough response teams at the ready.
If you need urgent care (you wouldn't need an ambulance otherwise), you can go to any emergency room in the US and they WILL treat you regardless of your ability to pay. That is the law here (or was until today anyway).
Oops, sorry I was thinking of the UK fire-brigade when I wrote the first part.
However, the UK ambulance service should operate in the same way as the fire brigade and charge for false and frivolous call-outs. Just because health care is free, doesn't mean that people using the health-care system inappropriately should get a free ride.
In Australia, ambulance transport is not covered by Medicare (which is pretty stupid IMO), but it is covered by most private health insurances (which usually make you pay an excess/residual for each incident). And in most states/territories, it is an offence with potentially large fines (and possible jail time) for anyone making a false emergency call - whether it be ambulance, police or fire.
The solution is simple and I'm quite flabbergasted that the UK doesn't impose some sort of penalty for abuse of its healthcare services.
Low priority, high priority, whatever... It's free!!
The UK still have patients waiting in the parking lot in ambulances to avoid starting the waiting room clock? Last I heard 'they' were going to outlaw that. 'They' will then have to delay dispatching.
Not a whole hell of a lot, and the more you expect it to do the less you will get from it.
U.K. is a shinning example of this.
Tsukasa: All I really want, is to be left alone...
And of course, there aren't any people in the USA who get drunk and abuse emergency services, plus as soon as you 'socialize' health care, any fines and other legal consequences mysteriously vanish from the law books.
Who is John Cabal?
... it's a feature! Now victims of falls from more than six feet can die at home, rather than in the horrible NHS-run hospitals!
"Only two things are infinite, the universe and human stupidity, and I'm not sure about the former."
This is just another way to cut down on patient care costs when you have nationalized health care... never admit them.
Cheers,
Dave
They that can give up essential liberty to obtain a little temporary safety deserve neither safety nor liberty.
Ben
Wish it were a joke, or that I'm being sarcastic. Drunk isn't the start of stupid; it's just an invitation to the party, a lot of people are there already, not a shoelace is tied.
This is why we need a Professional Engineering certificate for 'Software Engineers' and a degree that prepare them for it.
There is no reason why I as a mechanical engineer should have to get certified to work on simple things like bridge refits, HVAC and the like and a software engineer/programmer/code monkey with no required qualifications can program anything up to and including life support, emergency dispatch and weapon systems.
An Education is the Font of All Liberty
This should really be a discussion about software testing and change verification. A more likely scenario might be a bureaucrat committee decided to change the fall priority maybe even based on some good empirical data and instructed some manager or the software vendor to make the change. Said agent has made the change as instructed (like a good robot), and only the change instructed, and this is the result.
On investigation you may find one or more of the following evaluates true:
- Someone decided the change was so minor the software change and verification process could be bypassed entirely
- The owner didn't like the price the vendor wanted to or was anticipated to charge for this 'minor' change and decided they could do the job locally
- The change specification was utter crap
- The verification was utter crap
I've worked as a Paramedic under the Advanced Medical Priority Dispatch System (AMPDS).
Whether you are given a Cat A or B generally makes no difference in the response time of the crew to the scene - i.e. they always drive as fast as they safely can no matter what the emergency.
Incorrect triage by the communications centre is routine. This is usually not the comcen's fault - it is almost always incorrectly reported information from the caller. Things like whether there is a pulse or not, whether they are breathing or not, whether they are bleeding or not, are often incorrectly reported from panicky callers.
Or you can get correctly triaged responses with totally different results. You might get a call saying a patient has severe gastric pain which ends up being a myocardial infarction.
You might get a call from a patient with severe difficulty breathing (which is a cat B emergency) only to find they are having a panic attack or have a sore knee (patient lie all the time to get either free drugs, attention, a free trip to hospital, etc.).
In regards to the height of a fall problem consider this. A 6 foot plus tall person falls 6 plus feet to the ground when they pass unconscious from standing - yet the person reporting won't usually think of saying they fell six feet (we're talking head impact here - not much else matter until you're falling from really big heights and can start shattering lots of bones). A very common example of misreporting from callers.
Well the US built software didn't quite fit with the SI units they used; when they turned the 6 foot fall into a 1.8288 metre fall there was a slight disconnect in the statement of the problem. So basically it is a translation error, instead of crashing into a planet, they just sent less prioritized help. I kinda also want to point out that there is no sure way to say that the downgrade of the call was directly linked to the death of the patient.
Forbidding the staff to exercise judgement in an emergency call center is the best illustration I've come across in a long time of what Barry Swartz refers to as the "war on wisdom".
Barry Schwartz on our loss of wisdom
From the online transcript:
The truth is that neither rules nor incentives are enough to do the job. How could you even write a rule that go the janitors to do what they did? And would you pay them a bonus for being empathic? It's preposterous on its face. And what happens is that as we turn increasingly to rules, rules and incentives may make things better in the short run, but they create a downward spiral that makes them worse in the long run. Moral skill is chipped away by an over-reliance on rules that deprives us of the opportunity to improvise and learn from our improvisations. And moral will is undermined by an incessant appeal to incentives that destroy our desire to do the right thing. And without intending it, by appealing to rules and incentives, we are engaging in a war on wisdom.
This is actually a bit of a talking head lecture. Not much sizzle, but a message worth repeating.
There ought to be nowhere to hide for a bureaucrat forbids the use of human wisdom when the rigid system that ensues makes a total hash of things.
In other news:
"A flaw in Slashdot's sensationalistic story submission system may have caused hundreds to accidentally RTFA.."
Maybe they assumed that a fall from that height would usually kill the person anyway, so there isn't much point in hurrying.
That would be even stupider. A fall from 8 feet may inflict anything from minor bruising to serious or life-threatening injury, such as compound fracture or head/neck injuries. Only in a few cases would those injuries be untreatably mortal.
As one anecdote, I have fallen from more than 10 feet up, while traveling horizontally at about 30 km/h (the horse and I unexpectedly took different paths over a jump). I collected some bruises, but was able to re-mount and continue over the rest of the course. Medical attention was neither needed nor sought, and I was over 50 years old at the time. Had there been solid obstacles such as rocks in my unintended landing zone, the outcome might have been considerably worse.
Those who can make you believe absurdities can make you commit atrocities. - Voltaire
About 15 or 20 years ago, a Mexican guy, was helping a licensed contractor put a new roof on a two story home, and fell about 12 to 14 feet. The home had a very steep roof. I did not actually see it happen. From what I heard, he landed on rough ground between several boulders, smaller rocks and cactus. He then just laid there for several minutes before getting up. When he finally got up, apparently he was OK.
The steep high roof was not one which I would have dared to climb myself. That was why I was glad to hear that an experienced licensed contractor had been hired to do the job. Of course this being Arizona, several Mexican guys who did not speak English showed up to help do the work.
I also know of a woman, who has had some reoccurring lower back pain even since falling off of a 300 foot cliff, while hiking many years ago. I assume that she must have actually slid much of that distance, perhaps falling and bouncing, here and there a little along the way. I don't know the exact details, but perhaps she might not have fallen more than 6 feet on any one bounce. Her total 300 foot fall, could then perhaps be considered to be a series many, less than 6 foot falls.
Several decades ago, one of my grandmothers once lost her balance and hit her head and died from that injury. She was not tall enough, to have fallen more than 6 feet.
I also know of two instances where guys have fallen off of their own roofs, and have had serious life long back problems ever since then. Injuries like that on ladders or roofs are actually quite common.
in my opinion at least.
However, I think that most Americans seem to be arguing that their system is the best *because of the quality* and most people who have been exposed to a universal health-care system like we have up here in Canada, are arguing *because its affordable*.
I have no doubt that the quality of treatment available in the US is absolutely top notch. No doubt whatsoever. I am also equally convinced that from the point of view of how paying for that treatment affects the average individual, the universal socialized systems are generally superior. Not always superior for everyone, but in general superior. I don't think that there can be much argument there to be honest.
Cases in point:
* My wife's friends down in Phoenix, who could only afford health insurance for *him*, his wife had to make do without. They lived their lives hoping that she didn't get seriously ill. As it stood, it was costing them hundreds of dollars a month for their insurance (this was a decade or two ago mind you, things might be better now, I don't really know).
* A good friend who was diagnosed as having a brain tumour up here in Canada. Within a week he was in the hospital, had the tumour removed by a top notch surgeon, and was out of the hospital a week or two after that. The surgery was completely successful I am pleased to say. Total cost: nothing whatsoever beyond whatever he pays for his health-care insurance (likely around $60 a month, but the amount is based on your income so it might be less than that).
* My mother, who was treated for lung cancer over a year long period. She received multiple chemotherapy treatments, was hospitalized a few times etc. She did die sadly, but the total cost to her estate was $50 for the trip to the hospital for pallative care. No other costs were incurred.
* I have never had to pay a single dollar more than my regular health-care cost based on my income. I am 50 years old. Everything is covered, except sadly dental work. Ten years of that was admittedly covered by the military when I was a member, but the rest has been covered by the regular health-care system.
* I don't know *ANYONE* who has had to pay a huge bill for treatment or surgery (actually I don't know anyone who has had to pay extra period), don't know anyone who has not been covered for any treatment they needed, don't know anyone who has gone broke as a result of a major medical problem, don't know anyone who has been stuck on a waiting list who suffered as a result, etc.
While I have no doubt that someone in the US who has good insurance is effectively covered and gets the treatment they need etc, there is apparently a huge percentage of the US population who have no insurance coverage - I believe an article I read on CNN stated something like 35m to 55m but I can't recall. That is absolutely insane to be honest. I personally have to consider anyone who argues that the current US system works and is superior to a more socialized system is honestly so selfish and ignorant that they could be considered truly evil.
I can understand that many of you have such a strong desire to ensure you never do anything for a fellow citizen that you would rather they die than help them out financially by say, paying some taxes that spread the burden out, but I can't understand it *at all*.
"The first time I got drunk, I got married. The second time I bought a chimpanzee, after that I stayed sober" Arian Seid
So not actually a flaw in the application at all, but a flaw in whoever makes decisions like these in terms of absolute quantities.
Some people have fallen thousands of feet after parachutes failed to open and survived with maybe a broken leg.
And some other people manage to drown in 3 inches of bathwater.
Should we really be applying math to these kinds of decisions, when common sense is really all we need ?
Isn't it interesting that the blame is put on some 'flaw in a system', where, in truth, the blame is simply a catastrophic error in judgment by a committee. Although its not stated, the odds are that the committee did not include members with medical training. Any fool can see that falling 6' is likely to cause fatal injuries, especially to the elderly. Where are the individuals who made this absurd change? Who are they? Are they vulnerable to law suite or any sort of consequences? The 'system' worked. Those responsible for defining what the 'system' should do did not work in the interests of the public. Why try to hide them? Are there other committees making similar 'money-saving' decisions? tkjtkj, m.d.
"There are 11 kinds of people: those who know binary, those who don't, and those who could not care less!"
This is why some things really don't work to have a worker drone in India answering 911 (999 in England?) and going down a list of answers. Its fine for first tier helpdesk as long as second tier knows what its doing but 911 calls should always be top tier.
This is also an unintended down fall of most current development approaches. In requirement based or use case based developments, if the customer gives poor examples they will get poor results.
If a customer operating out of death valley orders an auto-pilot system and fails to specify handling of below sea level altitude (ok, already handled by FAA rules but still makes a good mental example if you don't nitpick it) and a plane crashes because the auto-pilot inverts below sea level it could be considered the customer's fault, not the developer's.
not a 12-foot fall. You don't fall 12 feet down stairs. You fall 12 feet off a 12 foot cliff. I'd suspect that the injuries from the latter tend to be more life-threatening than injuries from the former.
Eloi are stupid, throw morlocks at them!
But if you are poor, God help you, because you can't afford it.
In most cases, poor people are covered under Medicaid or similar programmes. The middle class is covered by private plans. The elderly have Medicare. There are relatively few people who 1) would want to have health insurance and 2) do not qualify for Medicaid/etc. Many of the insured are either the "young invincibles" or individuals who could qualify for Medicaid but never bothered to fill in the required paperwork (or simply don't know that they qualify).
You are as full of shit as a Thanksgiving turkey.
My wife and I are living examples of how wrong you are. We were middle class with incredibly shitty health insurance, until my wife developed cancer. Now we have no health insurance (because we can't afford the premiums for even the incredibly shitty insurance we used to have), no income (because the free-market buccaneers fucked the economy in the ass), and no possible access to Medicaid or Medicare (despite having both paid Medicare taxes for decade), because we're too young for the latter, and our car is too new for us to qualify for the former.
(To qualify for Medicare, you have to have less than $2,000 in liquid assets, and your car has to be worth no more than $3,500.)
The whole point of the health care "reform" bill was to extend coverage to 30 MILLION Americans who (like us) can't afford or obtain coverage under the present, insanely-anti-consumer system. Just because the Frankenstein's monster that the House passed is full of flaws, holes, and Congressional blowjobs for the health insurance industry doesn't obviate the need for reform. We still have no insurance. We have plenty of medical debt, though - and more being added all the time.
So how does that fit into your simplistic world view, Mr. "Many of the insured ... could qualify for Medicaid but never bothered to fill in the required paperwork?"
Check out my novel.
I'm a paramedic in the US and thats pretty misleading. First the definition of a fall changes with what sort of fall it is. Generally a fall of 6 feet going priority 1 means they fell off scaffolding (or a vertical drop of 6 feet). Otherwise we use approx 2XBody-height in situations where people fall down stairs. However there is a caveat that if the patient has altered mental status/chest pain/shortness of breath it gets bumped up to a priority 1. This is not the softwares fault, its the dispatchers not paying attention to the signs of serious injury. EMD (Emergency Medical Dispatch) only works when you have competent people behind it.
People also need to realize that the accident rate (at least in the US) is 150% higher for ambulances/firetrucks/police cars who are going priority one. Would you rather an ambulance get there 2-3 min earlier or not at all. People also need to learn what is an emergency vs. taxi ride; nose bleeds, gold tooth pain (yes I've had all of these calls recently) do not require an ambulance, but because you call we have to go using the limited resources we do have. I work in a city of a population of about 100,000 and there are 4 ambulances TOTAL running emergency calls. Think about that next time you have a cold for a few days and want an ambulance.
Bad title...should read "Dumbass people tell computer that falling 12 feet down on to your head not life threatening"
...as it is a flaw in the government committee. Perhaps it would be better to fix that flaw before more people die because "it wasn't priority."
As if, the computer suddenly has a medical degree?
--- I am known for the ones who want to find me on the net. Is that a privacy risk or a privilege? One might wonder..
Reminds me http://imgur.com/iPVTA.gif
I'd like to buy homeland for our 10 million people. http://twitter.com/mahadiga
There are enough cases, not documented "by the book"; that's probably why they got operators.
Stop letting them depend on their computer system too much and use their own judgement. Of'course the other side could forget/alter important and vital information; but still the operator should be the one judging what's a top emergency or not.
If they aren't able to judge, based on the received information anymore, then why don't they put automatic attendants instead of real live operators?
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I am not convinced in software based expert systems for life critical applications like such.
There are standard questions to be asked, but there are also extra factors sometimes which should be taken into consideration; which a computer will sure not do in all cases.
These systems are still programs and limited by their initial input. A competent human decision is worth gold for such life critical infrastructure.
If these accidents happen that much on a year, I'd rather think these expert systems are good for help-desk support but not for an emergency center.
--- I am known for the ones who want to find me on the net. Is that a privacy risk or a privilege? One might wonder..